比較窄頻影像及傳統白光影像在區別大腸息肉之診斷表現

Diagnostic Performance in Differentiating Colorectal Polyps : Narrow Band Image and Conventional White Light Image

蔡明宏(Ming-Hung Tsai)

指導教授 ： 沈偉誌

亞洲大學/資訊學院/生物資訊學系碩士在職專班/碩士(2011年)

摘要

大部分的大腸癌多經由良性的腺瘤演變而形成，因為有癌化的風險，腺瘤必須切除。如果我們能正確的分辨腺瘤與非腺瘤病灶，就可以避免非腺瘤的過度治療。
窄頻影像系統是新近發展的光學染色內視鏡，可以使得黏膜表淺的微細血管突顯，而沒有傳統染色內視鏡在觀察上需要人為噴灑染劑的不便。
為了提高診斷正確率，不論傳統染色內視鏡或窄頻影像系統，最好能搭配放大內視鏡，但是在臨床上，放大內視鏡的使用並不普遍。我們分析了36個息肉病灶在白光及窄頻影像下，其紅、綠、藍三種顏色的數位資料，除了窄頻影像紅光的SD及Kurt外，不論是否使用窄頻影像，兩者病灶在SD、Kurt、Entropy與Energy的特徵分析均呈現統計上的差異，可能是因為非腺瘤病灶呈現較均質黏膜表面。在窄頻影像中綠光的平均值在兩者病灶間亦呈明顯的差異，可能是腺瘤病灶具備較大的凹陷型態吸收較少的綠光而造成。在電腦輔助診斷的表現上，窄頻影像優於傳統白光，這與以往臨床上的研究結果相符。

關鍵字

窄頻影像 ； 白光 ； 大腸息肉 ； 電腦輔助診斷

並列摘要

The majority of colon and rectal cancers arise from previously benign adenoma through the adenoma-carcinoma sequence. Discrimination between neoplastic and nonneoplastic lesions is crucial to avoid overtreatment of nonneoplastic lesions. Narrow band imaging (NBI) is a new-developed optical chromoendoscopy to highlight microvascular structure upon mucosa surface without inconvenience of dye spraying used in conventional chromoendoscopy. Both conventional chromoendoscopy and NBI need magnifying colonoscopy to achieve high diagnostic accuracy, but magnifying colonoscopy are not routinely used in clinical practice. We analyze numerical data of red, green, blue components under white light (WL) and NBI in 36 polyps. Significant difference between two lesions is demonstrated in features including standard deviation (SD), Kurt, Entropy, and Energy for each components under WL and NBI except SD and Kurt on red component under NBI. The more homogeneous mucosa surface in hyperplasia polyp contributes to the presentation. The mean on green component under NBI also achieve significant difference that may result from less absorption over the larger pit area in adenomatous polyp. Accuracy of computer-aided diagnostic performance is higher by NBI than by WL that is compatible with previous investigations under clinical research without computer-aided analysis.

並列關鍵字

narrow band image ； white light ； colorectal polyps ； computer-aided analysis

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